The Black Lung Benefits Reform Act of 1977 awards compensation for pulmonary disability incurred as a consequence of employment as a coal miner. The intent of Congress as expressed in this act is simple and clear, but unfortunately administration of the act is difficult and often results in an unfair and inequitable distribution of public funds. Assessing disability by symptoms and measures of pulmonary function is not easy and often results in erroneous judgments. Disability, even when it exists, is rarely caused by coal particles alone but is usually the result of other factors such as cigarette smoking, which results in emphysema. A man in whom emphysema develops and who has a history of being a coal miner can receive compensation, while another victim of the same disease, who never worked in a coal mine, receives no compensation.
As might be expected the prospect of being awarded a government pension
Barclay WR. Black Lung Benefits. JAMA. 1980;243(23):2427. doi:10.1001/jama.1980.03300490045028